论文部分内容阅读
目的:探讨枣核引起肠梗阻与肠穿孔的CT征象及临床特征。方法:收集我院2011年以来枣核引起肠梗阻与肠穿孔的患者13例,其中7例被手术证实,6例通过病史和随访CT证实。所有患者均进行了腹部CT平扫检查及多平面重建(MPR)。结果:CT发现11例患者的枣核异物位于小肠,2例位于乙状结肠,异物位于小肠的患者中有5例发生在第6组小肠。6例患者CT主要表现为不全肠梗阻,梗阻远端可见纺锤形高密度影嵌顿肠壁,相应肠壁增厚,梗阻近端肠管内见食物团淤积,该组患者临床上主要表现为腹痛、腹胀伴恶心呕吐,腹痛一般表现为阵发性下腹疼痛;7例患者CT主要表现为肠穿孔,穿孔部位可见纺锤形高密度影两端穿破肠壁浆膜层,相应肠壁增厚,邻近脂肪密度增高及周围散在游离气体影。该组患者临床上主要表现为全腹持续性剧痛,间断加重。结论:腹部CT检查可以准确诊断枣核引起的肠梗阻与肠穿孔的急腹症;MPR可以完整显示枣核异物形态及与肠壁的关系,为临床治疗的选择提供帮助。
Objective: To investigate the CT signs and clinical features of jujube nuclei causing intestinal obstruction and intestinal perforation. Methods: Thirteen patients with ileocecal ileus and intestinal perforation were collected in our hospital from 2011, of which 7 were confirmed by surgery and 6 were confirmed by history and follow-up CT. All patients underwent abdominal CT scan and multiplanar reconstruction (MPR). Results: The CT findings of jujube nuclear foreign bodies in the small intestine of 11 patients, two in the sigmoid colon, and five in the small intestine of the foreign body occurred in the sixth group of small intestine. 6 cases of patients with CT showed incomplete intestinal obstruction, distal obstruction can be seen high-density spindle-shaped incarcerated intestinal wall, the corresponding thickening of the intestinal wall, proximal obstruction intestinal obstruction see food mass deposition, the group of patients clinically mainly abdominal pain , Abdominal distension with nausea and vomiting, abdominal pain is generally manifested as paroxysmal abdominal pain; 7 cases of CT showed mainly intestinal perforation, perforation site can be seen at both ends of the spindle-shaped high-density perforated intestinal wall serosa, the corresponding wall thickening, Adjacent to the increased fat density and scattered around the free gas shadow. The main clinical manifestations of this group of patients with persistent abdominal pain, intermittent increased. Conclusion: CT examination of abdomen can accurately diagnose the intestinal obstruction caused by jujube nucleus and acute perforation of intestine perforation. MPR can completely display the morphology of the foreign body of date jujube and the relationship with the intestinal wall, which can be helpful for clinical treatment.